Chapter 139 Cricothyroid membrane puncture
The two were resting under a tree on the roadside.
"You can drive when you get back later. Drive slowly. The key is not to panic. Especially when you see a lot of people in the car, you need to predict the traffic situation in advance. In an emergency, just don't make a mistake on the accelerator and brake. You were driving just now The throttle and brake can be switched easily, and the memory will be formed if you drive it too much. ”
Xiao Su summarized Yang Ping's driving just now, told Yang Ping all his years of driving experience, and taught it to Yang Ping.
Another couple on the roadside seemed to have had enough rest and got into the Honda SUV. Before getting in, the man didn't forget to look this way.
Yang Ping and Xiao Su took a rest. Xiao Su checked the battery of the car. It was enough and it was fully charged when they came out.
The two of them walked around the university town a few more times, and they were almost done practicing. Xiao Su took Yang Ping to practice reversing the car into the garage.
Xiao Su found parking spaces in parallel parking spaces, diagonal parking spaces, and perpendicular parking spaces, and asked Yang Ping to practice them all, and passed every event.
Yang Ping learns very quickly. He masters each item in one go. After practicing it several times, he still has his own experience.
After practicing very skillfully, the two found a self-service hot pot restaurant and followed the navigation there.
This hot pot restaurant is quite popular and the price is not expensive, only 100 yuan per person. The two of them found a booth by the window.
The mandarin duck pot bottom was brought to the table by the waiter. Yang Ping and Xiao Su picked out a lot of ingredients. They were also hungry and ready to eat to their heart's content.
"You learn things so fast. You became so proficient in one afternoon." Xiao Su put ingredients into the hot pot.
Yang Ping felt embarrassed: "I was going shopping with you, but now I am practicing driving with me."
Xiao Su said with satisfaction: "I've been shopping for several hours and that's enough. You see, I bought and ate. I'm so happy today!"
After Xiao Su had filled up the ingredients, Yang Ping put the lid on the pot, and the two of them waited for the hot pot soup to boil.
Xiao Su said carefully and considerately: "You go to the consultation on Tuesday and drive my car. When you return to the hospital next time, I will fully charge the battery. There is an area in the underground parking lot of our hospital full of charging piles. Then you go to the nearby First, there are charging piles in Area E on the third floor of its underground parking lot.”
"Are you familiar with Attached One?" Yang Ping heard her say this and even knew where the charging piles were.
Xiao Su nodded: "Those who drive electric cars know exactly where there are charging piles in G City. After all, charging piles are not as common as gas stations, so range anxiety is inevitable."
"This pure electric car feels like a mobile phone. It's very interesting. You don't have to refuel when you go home, but charge it. I will also buy a pure electric car when I buy a car in the future. It is environmentally friendly, healthy and silent." Yang Ping is interested in this electric car. .
"You should also buy this one. This one is available in black and in several colors." Xiao Su recommended.
Yang Ping shook his head like a rattle: "No, no, this is too expensive. I'll buy a BYD one, made in China."
"It seems that BYD's batteries are safer and can pass the acupuncture test." Xiao Su was able to keep up with the topic.
The two chatted while eating, ranging from daily life to surgical operations. Xiao Su asked for some professional knowledge that she did not understand, such as the use of a certain instrument and why a certain step was done. Yang Ping patiently answered the questions and felt that she It is really easy to learn, and he is really thinking about the steps of the surgery to better cooperate with the surgeon.
The ingredients were on the CD, Yang Ping asked Xiao Su what else he wanted, and was about to get up to pick out the ingredients.
Suddenly, there was a little noise in the store. Yang Ping turned to look. Following Yang Ping's gaze, Xiao Su also looked.
Someone had an accident. In the hall, a girl in her twenties fell to the ground.
Yang Ping and Xiao Su rushed over immediately to see what was going on.
"I was fine just now, but suddenly my face turned ugly and I fell down."
The girl's boyfriend had no idea at all and asked everyone for help in a panic. Then he picked up the phone and dialed 120, stammering while speaking.
"Sorry, give me a moment, I'm a doctor." A middle-aged man separated from the crowd and hurriedly squeezed in.
He simply judged the condition, felt under the xiphoid process, and began to perform heart compressions on the lower sternum. His technique was extremely skilled. This kind of proficiency was not just a simple training, but should be acquired through many years of long-term training.
The process of manual cardiopulmonary resuscitation is completely in accordance with the latest guidelines. Once you get up, it takes a few seconds to determine the consciousness, breathing, and carotid pulse, then start compressions, and then open the airway after compressions.
Use the forehead-pressing and jaw-raising technique to open the airway, check whether there is anything in the mouth that needs to be cleaned, then perform two mouth-to-mouth artificial respirations, and repeat cardiac compressions. The ratio of compressions to artificial respiration is 30:2.
This person should be a doctor, and he should be an emergency physician or ICU doctor. His decisive and smooth rescue operation is entirely due to his excellent professionalism.
Yang Ping also squeezed in, knelt on one knee on the ground, touched the carotid artery and nostrils, and checked the skin of the neck and limbs. There was a weak pulse in the carotid artery, and the heartbeat had not stopped. In this case, there is absolutely no problem with compression. Compression can help the weak heart pump blood. It does not necessarily mean that the heart has stopped beating completely.
There are some urticaria on the skin, allergic reaction! This is an allergic reaction! It is not sudden cardiac death. Acute laryngeal edema caused by allergic reaction, leading to suffocation.
When Yang Ping first obtained the system, he underwent first aid training, and later received physical examination training from the system's super training program, making him very confident in his judgment.
"Allergic reaction! Acute laryngeal edema! Open the airway urgently!" Yang Ping calmly reminded the middle-aged doctor.
"I'm open." The middle-aged doctor was very confident.
"Cricothyroid puncture or tracheotomy needs to be performed immediately!" Yang Ping made eye contact with him.
The middle-aged doctor did not stop pressing his hand, and his hesitation could be seen in his eyes.
In this emergency situation, whether it is cricothyroid membrane puncture or canal incision, both are invasive. If the judgment is wrong, it will bring adverse consequences, or the patient may not be saved, and he may face trouble.
Although the law stipulates that this kind of first aid will not be exempted from liability, but - many things are not as simple as imagined. After being a doctor for so many years, I have seen a lot of things.
The doctor and Yang Ping exchanged glances and wanted to free up the position for Yang Ping. Yang Ping immediately stopped him: "Keep pressing, and I will do the cricothyroid membrane puncture!"
Compression can help the heart pump blood, transport the remaining oxygen in the blood into important organs, and maintain the perfusion of important organs, especially the brain tissue, which can only tolerate hypoxia for four minutes. If breathing and circulation are not restored within ten minutes, the brain will Irreversible damage will occur.
"Quick, a knife and a clean straw! A sharp knife or small scissors will do; a straw of normal size will do." Yang Ping shouted to the crowd.
I originally wanted to use alcohol or high-concentration alcohol to sterilize the knife and disinfect the throat area, but it takes time to find these things. This kind of acute laryngeal edema can cause complete obstruction of the respiratory tract, and death will occur within a few minutes. Save time and eliminate the need for disinfection.
Knives and straws are easy to find. There was one person in the crowd who carried a Swiss Army knife with him. He took out the sharp knife and handed it over immediately. There were straws at the service desk in the store, and the waiter brought one over, in different sizes.
Xiao Su took the knife, picked out the straw, and squatted next to Yang Ping, serving as an assistant at any time. Scissors, someone handed Xiao Su another small pair of scissors.
The manager of the hot pot restaurant was sweating profusely. If something happened, he would be in trouble.
Yang Ping quickly constructed a local anatomical image of the larynx in his brain.
A slight touch with the finger confirmed the location of the cricothyroid membrane in the soft part between the thyroid cartilage and the epiglottis cartilage.
Xiao Su handed over the knife, and Yang Ping stabbed the tip of the knife accurately. A feeling of failure appeared. When the tip of the knife entered the trachea, he immediately stopped and pulled it out, and gently inserted the straw into the trachea.
The straw has been trimmed by Xiaosu, the tip is removed, and a suitable length is reserved at one end. Fold the straw at a certain angle in the bending area.
In this way, it is very convenient for Yang Ping to insert the straw, which can be inserted along the trachea without causing damage to the inner wall of the trachea.
Laryngeal edema blocks the airway. Now puncture below the blockage to re-establish an artificial passage for air and avoid the blockage.
Successfully ventilated! The sound of air flowing in and out was like a whistle, Yang Ping touched the carotid artery, and then looked at the patient's face and lips. The pale color slowly turned red.
Seeing this situation, the middle-aged doctor also stopped the heart compression.
"Acute laryngeal edema caused by allergies, let her lie down, don't move her, wait for the ambulance to come." Yang Ping did all this and waited by the side.
The carotid pulse can now be palpated and the blood pressure can at least be measured, indicating that the symptoms of acute laryngeal edema are severe and the symptoms of shock are not very severe.
"What else do you need from me?" the middle-aged doctor said, full of admiration for his colleague's performance.
Yang Ping said: "Okay, wait for the ambulance."
"Already called 120!" the girl's boyfriend said while crying. He was also a young man who had not experienced anything, and he cried like a child.
The middle-aged doctor's face felt a little hot. This young doctor was so courageous. Just now, he made accurate judgments and acted decisively, performing cricothyroid membrane puncture without blinking an eye. In contrast, he was thinking about everything before and after, hey! Time has worn away the passion and the courage has weakened.
Seeing that Yang Ping was very calm throughout the whole process, rescuing the patient without any panic, the doctor's professional sacredness and sense of honor couldn't help but surge into his heart.
Middle-aged doctors have lost this sense of professional sanctity and honor for a long time, and now they are finding it again.
A long time ago, this sense of mission was only felt when I first entered school and took the medical oath.
"Thank you. I am very familiar with cricothyroid membrane puncture, but my judgment is not accurate; even if the judgment is correct, I dare not use it; even if I use it, I will not be as experienced as you. To complete it with a knife and a straw, I will definitely be full of thoughts. Look for a needle, at least a ballpoint pen or a pen or something like that,” the doctor said guiltily.
"You're right. With this invasive rescue method, it's sometimes difficult to make a decision." Yang Ping understood him. Not everyone has their own confidence.
"This doctor is so amazing!"
"The thing I admire most is the doctor."
"If there hadn't been a doctor eating just now, this girl would have been in trouble. She's so lucky."
"Yes, why did it happen suddenly?"
"This man, I don't know what will happen."
The crowd was talking quietly, saying something here and there, and some of them began to return to the table and continue eating.
Yang Ping checked the patient again and found that there were indeed many urticaria on the skin. How could he be allergic?
There are also reports of people allergic to penicillin causing allergies after accidentally eating food such as chicken, fish and meat containing penicillin residues, but this is rare.
As for what caused the allergy, it is left to the doctors at the follow-up treatment hospital to judge. After all, this will affect the reputation of the store and cannot be jumped to conclusions.
Yang Ping just analyzed it in his mind and did not say it out loud.
Doctors from 120 finally arrived. Doctors, nurses, and first responders carried a stretcher. Under the guidance of the store clerk, they arrived at the scene of the accident.
"What's going on?" the visiting doctor asked immediately.
"Acute laryngeal edema. You see, there are urticaria all over the body. It may be a type 1 allergic reaction caused by exposure to some allergen. I just had a cricothyroid puncture, and a suction tube was inserted to open the airway. The whole No disinfection was done during the operation. ”
Yang Ping briefly introduced the situation. The visiting doctor checked the patient and said, "Okay, leave it to us! It should be an allergic reaction! Adrenaline——"
The visiting doctor immediately ordered the nurse to administer medication. The nurse had just established an intravenous channel and hung up a bottle of normal saline.
After the epinephrine injection, the patient was transferred to the stretcher. The first responders carried the stretcher. The visiting doctor said to Yang Ping and the middle-aged doctor: "Thank you for your hard work!"
The person was picked up by an ambulance, and no one called 110. The police also came. The manager of the hot pot restaurant, several witnesses, and Yang Pinghe and a middle-aged doctor were all questioned by the police. I also left my phone number and will cooperate with the investigation at any time.
The police sealed up the hot pot that the patient had just eaten and took it back for testing to rule out food poisoning.
When everyone saw this, most of them didn't dare to eat. They didn't feel it at first and thought it was just a sudden illness.
Now the police have taken away all the remaining hot pot food from the patients, so they dare not eat it. Some even feel a little dizzy, and some feel the need to go to the hospital.
Everyone dispersed, and it was time for Yang Ping and Xiao Su to go back. Yang Ping drove and Xiao Su was in the passenger seat, back to the hospital.
After returning to the hospital and coming out of the underground parking lot, when the two of them parted, Xiao Su handed Yang Ping a bag in his hand, which was the clothes Xiao Su said he had bought for his family.
"You worked hard today. This is a reward for you. You can wear it for the consultation on Tuesday." Xiao Su's face was red and she was full of shyness.
Yang Ping took the bag and was a little surprised. Wasn't it bought for her family?
"How do you know my size?" Yang Ping asked innocently.
"I'll learn from you!" Xiao Su turned around.
He turned around and waved to Yang Ping: "Go to rest early!"
(End of chapter)